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ALERT Presentation:
A Handover OSCE to Measure Skills
in Transitions of Care
Joseph Lopreiato and Kathleen Wortmann
Uniformed Services University
INSPIRE @ IMSH 2017 – Orlando, FL, USA
International Network for Simulation-based Pediatric Innovation, Research and Education
• Conducting accurate transitions of care between
teams is a core competency.
• Measuring performance in this domain in the clinical
world is difficult and rarely done.
• There is a need to gather performance data on
trainees in this area in order to offer feedback.
International Network for Simulation-based Pediatric Innovation, Research and Education
Background
• Population: Pediatric Interns
• Intervention: Handover OSCE
• Control/Comparison: peers
• Outcome(s): Handover skills
International Network for Simulation-based Pediatric Innovation, Research and Education
PICO / Research Question
• We introduced a handover station into our annual pediatric
intern clinical skills examination (CSE).
• 126 pediatric interns over three academic years from two
different pediatric training programs in the USA.
• Seven OSCE stations with five cases portrayed by SPs.
• The final station was a handover scenario.
• The assessor used a previously validated 10 item
observation tool to measure performance after all three cases
had been presented (IPASS SCO).
International Network for Simulation-based Pediatric Innovation, Research and Education
Approach / Design
3 Year Results
Domain
(Max possible score)
% of Students Who Scored
Correctly
Patient Summary 90%
Severity of Illness 55%
Action List 88%
Contingency Plan 90%
Avoiding miscommunications or transfer of
erroneous information 90%
Read back key information 67%
Encourage the receiver to ask questions to check for
understanding 79%
Comparative Results
Domain
(Max possible score)
2013
(Mean Score)
2016
(Mean Score)
T-Tests
Overall Handover (50) 72% 82% (p<0.05)
Handover Elements
Domain (25)
64% 77% (p<0.05)
HE+Prioritizing and
Engaging Domains (10)
51% 81% (p<0.05)
HE+PE+Omissions,
Miscommunication and
Tangential Domains (15)
81% 91% (p<0.05)
1. What would make this data seem more
exciting?
2. Is it necessary to have a control group?
3. Can the results be generalized?
International Network for Simulation-based Pediatric Innovation, Research and Education
3 questions to improve study
• ALERT Presentation: Jan 2017
• IRB Submission - pending
• Recruitment / Data Collection: ongoing
• Data Analysis: Done
• Abstract Presentation: ASPE June 2017
• Manuscript Preparation: not yet
International Network for Simulation-based Pediatric Innovation, Research and Education
Timeline
At INSPIRE @ IMSH 2017:
In 2 months: peer review
International Network for Simulation-based Pediatric Innovation, Research and Education
Goals to accomplish
Joseph Lopreiato
Uniformed Services University
joseph.lopreiato@usuhs.edu
International Network for Simulation-based Pediatric Innovation, Research and Education
Contact Information

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Alert 2017 lopreiato - a handover osce to measure skills in transitions of care updated

  • 1. ALERT Presentation: A Handover OSCE to Measure Skills in Transitions of Care Joseph Lopreiato and Kathleen Wortmann Uniformed Services University INSPIRE @ IMSH 2017 – Orlando, FL, USA International Network for Simulation-based Pediatric Innovation, Research and Education
  • 2. • Conducting accurate transitions of care between teams is a core competency. • Measuring performance in this domain in the clinical world is difficult and rarely done. • There is a need to gather performance data on trainees in this area in order to offer feedback. International Network for Simulation-based Pediatric Innovation, Research and Education Background
  • 3. • Population: Pediatric Interns • Intervention: Handover OSCE • Control/Comparison: peers • Outcome(s): Handover skills International Network for Simulation-based Pediatric Innovation, Research and Education PICO / Research Question
  • 4. • We introduced a handover station into our annual pediatric intern clinical skills examination (CSE). • 126 pediatric interns over three academic years from two different pediatric training programs in the USA. • Seven OSCE stations with five cases portrayed by SPs. • The final station was a handover scenario. • The assessor used a previously validated 10 item observation tool to measure performance after all three cases had been presented (IPASS SCO). International Network for Simulation-based Pediatric Innovation, Research and Education Approach / Design
  • 5.
  • 6. 3 Year Results Domain (Max possible score) % of Students Who Scored Correctly Patient Summary 90% Severity of Illness 55% Action List 88% Contingency Plan 90% Avoiding miscommunications or transfer of erroneous information 90% Read back key information 67% Encourage the receiver to ask questions to check for understanding 79%
  • 7. Comparative Results Domain (Max possible score) 2013 (Mean Score) 2016 (Mean Score) T-Tests Overall Handover (50) 72% 82% (p<0.05) Handover Elements Domain (25) 64% 77% (p<0.05) HE+Prioritizing and Engaging Domains (10) 51% 81% (p<0.05) HE+PE+Omissions, Miscommunication and Tangential Domains (15) 81% 91% (p<0.05)
  • 8. 1. What would make this data seem more exciting? 2. Is it necessary to have a control group? 3. Can the results be generalized? International Network for Simulation-based Pediatric Innovation, Research and Education 3 questions to improve study
  • 9. • ALERT Presentation: Jan 2017 • IRB Submission - pending • Recruitment / Data Collection: ongoing • Data Analysis: Done • Abstract Presentation: ASPE June 2017 • Manuscript Preparation: not yet International Network for Simulation-based Pediatric Innovation, Research and Education Timeline
  • 10. At INSPIRE @ IMSH 2017: In 2 months: peer review International Network for Simulation-based Pediatric Innovation, Research and Education Goals to accomplish
  • 11. Joseph Lopreiato Uniformed Services University joseph.lopreiato@usuhs.edu International Network for Simulation-based Pediatric Innovation, Research and Education Contact Information